Earlier this morning, the Supreme Court affirmed the constitutionality of the Affordable Care Act. We will provide a more complete summary this afternoon, but here are the essential holdings. First, by a 5-4 vote, the individual mandate requiring most Americans to maintain "minimum essential" health insurance …
Maureen Maly Comments on the Upcoming Supreme Court Health Care Decision in Inc. Magazine
June 26, 2012 Leave a Comment
The U.S. Supreme Court’s ruling on the Affordable Care Act is expected to be handed down by the end of June. In the article, “Inside the Supreme Court Health-Care Decision,” Inc. magazine explored the implications of the potential rulings for small businesses. If the Supreme Court strikes down the health …
Additional Guidance on SBCs Issued
May 29, 2012 Leave a Comment
On May 11, the DOL issued FAQs about Affordable Care Act Implementation (Part IX); like the last FAQs (Part VIII) issued, this set of 14 FAQs discusses implementation of the Summary of Benefits and Coverage (“SBC”) provisions of PPACA. Here are some of the topics which are addressed: FAQ 1: Expanding on …
Calculating the Patient-Centered Outcomes Research Fee
May 24, 2012 Leave a Comment
Last month, Treasury released proposed regulations regarding fees for Patient-Centered Outcomes Research (PCOR) and the Patient-Centered Outcomes Research Institute (PCORI). As you may recall, the Affordable Care Act established a new Institute to study patient-centered outcomes, funded by a PCOR fee. This fee …
The ZPICs are Here! Is Your Organization Ready?
April 24, 2012 Leave a Comment
Effective April 24th, 2012, Cahaba Safeguard Administrators, LLC, the Zone Program Integrity Contractor (ZPIC) for Zone 3, is fully operational. Zone 3 includes the following states: Minnesota, Indiana, Michigan, Illinois, Ohio, Wisconsin and Kentucky. Implementation of a ZPIC contractor in Zone 3 was delayed …
CMS Publishes FAQs Limiting SRDP Financial Analysis to Four-Year Reopening Period
April 20, 2012 Leave a Comment
CMS has released four new FAQs regarding the applicable reopening period and “look back” period for potential Stark violations disclosed through the voluntary Self-Referral Disclosure Protocol (SRDP). The new FAQs clarify that a disclosing party may limit both (i) its disclosure of the total amount of …